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IGGY Study Guide- Chapter 43
Terms in this set (22)
Which statement about the relapsing-remitting type of multiple sclerosis (RRMS) is accurate?
A. It involves a steady and gradual neurologic deterioration without remission of symptoms.
B. It begins with a relapsing-remitting course and later the symptoms becomes steadily and progressively worse.
C. It is characterized by frequent relapses with partial recovery but not a return to baseline.
D. It is characterized by symptoms developing and resolving in a few weeks to months, and the client returns to baseline.
Which questions will the nurse ask a client, with increased fatigue and stiffness in the extremities, that will assess whether the symptoms may be associated with multiple sclerosis (MS)? Select all that apply.
A. "Has anyone in your family been diagnosed with multiple sclerosis?
B. "Have your symptoms gotten worse over time?"
C. "Are you having trouble breathing with slight exertion?"
D. "Which factors seem to make your symptoms worse?"
E. "Have your symptoms come and gone over time?"
F. "Are you having headaches that occur with stress?"
What will be the nurse's first intervention when a client states, "I've been dealing with the symptoms of MS for so long. Why won't anyone help me?"
A. Encourage the client to verbalize his or her feelings and frustrations.
B. Help the client locate and make an appointment with a specialist.
C. Ask the client to describe in detail the symptoms and past treatments.
D. Give the client a brochure about the diagnosis and treatment of MS.
Which priority teaching point will the nurse be sure to include when instructing a client with MS about the prescribed drug fingolimod?
A. "You must be carefully monitored for allergic reactions because the level of fingolimod tends to build up in the body."
B. "We will need to teach you how to check your pulse because fingolimod can cause slowing of your heart rate."
C. "Fingolimod will improve your ability to walk, but will also increase the risk for seizure activity."
D. "Fingolimod will decrease the frequency of clinical relapses, but there is an increased risk for stroke."
Which nursing assessment findings support a client's diagnosis of multiple sclerosis (MS)? Select all that apply.
A. Intention tremors
E. Respiratory distress
Which are purposes of the interprofessional team with regard to management of clients with multiple sclerosis (MS)? Select all that apply.
A. To modify the disease's effects on the immune system
B. To cure the client's illness
C. To prevent exacerbations
D. To manage symptoms
E. To improve function
F. To maintain quality of life
With which member of the interprofessional team will the nurse collaborate to improve the symptoms of MS that affect mobility?
A. Registered dietician nutritionist
B. Orthopedic surgeon
C. Physical therapist
D. Speech-language therapist
Which measure will the nurse recommend to prevent harm when a client with MS is discharged home?
A. Avoid exercising outside.
B. Immediately adapt the home for wheelchair access.
C. Keep the home free of clutter.
D. Install a ramp to the door of the home.
Which assessment will the nurse perform to monitor a likely coexisting complication in a client with MS who has dysarthria?
A. Check the client's gag reflex and ability to swallow.
B. Watch the client walk and note smoothness of gait.
C. Ask the client to use a pencil to write out a sentence.
D. Have the client stand with eyes closed and observe for swaying.
Which is the best action for the nurse to take when a client with MS develops diplopia?
A. Obtain a prescription for referral for corrective lenses.
B. Teach the client scanning techniques, turning the head from side to side.
C. Apply an eye patch alternating it from eye to eye every few hours.
D. Use prophylactic bilateral patches to both eyes during the night hours.
Which integrative/complimentary therapies will the nurse recommend to a client with multiple sclerosis? Select all that apply.
B. Herbal therapy
D. Conservation therapy
F. Relaxation and meditation
Which statement best describes hyperflexion as a cause of a client's spinal cord injury?
A. Hyperflexion occurs most often in vehicle collisions in which the vehicle is struck from behind or during falls when the client's chin is struck.
B. Hyperflexion is a sudden and forceful acceleration (movement) of the head forward, causing extreme flexion of the neck.
C. Hyperflexion results from diving accidents, falls on the buttocks, or a jump in which a person lands on the feet.
D. Hyperflexion results from injuries that are caused by turning the head beyond the normal range.
Which questions will the nurse be sure to ask EMS when an unconscious client with a cervical spinal cord injury (SCI) is brought into the emergency department? Select all that apply.
A. What was the location and position of the client immediately after the injury?
B. Has the family been notified for permission to begin treatment?
C. What symptoms occurred immediately after the injury and what changes have occurred since then?
D. What type of immobilization equipment was used at the site and were there problems with transport?
E. What treatments were given at the site of injury and during transport?
F. Does the client have a history of any respiratory problems or difficulties?
At what rate does the nurse set the infusion pump for a client with a spinal cord injury (SCI) to receive the prescribed 500 mL of dextran over 4 hours?
A. 75 mL/hr
B. 100 mL/hr
C. 125 mL/hr
D. 150 mL/hr
Which is the initial priority action for the nurse when admitting a client with a cervical spinal cord injury?
A. Spinal cord immobilization
B. Assessment of client's airway, breathing, and circulation
C. Evaluation of pulse, blood pressure, and peripheral perfusion
D. Checking bodily sites for hemorrhage
What findings would the nurse expect when caring for a client who is experiencing spinal shock?
A. Stridor, garbled speech, or inability to clear airway
B. Bradycardia and decreased urinary output
C. Hypotension and a decreased level of consciousness
D. Temporary loss of motor, sensory, reflex and autonomic function
What is the best term for the nurse to use when documenting a client's paralysis of both lower extremities?
Which new-onset symptoms indicate to the nurse that a client with spinal cord injury (SCI) is experiencing autonomic dysreflexia (AD)? Select all that apply.
A. Sudden hypertension with bradycardia
B. Flaccid paralysis
C. Blurred vision
E. Profuse sweating of face, neck, and shoulders
F. Severe throbbing headache
Which actions will the nurse take when caring for a client with a spinal cord injury who is experiencing autonomic dysreflexia? Select all that apply.
A. Raise the head of the bed.
B. Check the client's bladder for distention.
C. Place a condom catheter on male clients as necessary.
D. Give nifedipine or nitrate as prescribed.
E. Monitor blood pressure every 10 to 15 minutes.
F. Check the client for fecal impaction.
Which observation indicates to the nurse that a quadriplegic client's spouse understands teaching about performance of assistive coughing (quad cough)?
A. The spouse assists the client into a wheelchair and coaches deep coughing.
B. The spouse places hands on the client's lateral chest and pushes inward on exhalation.
C. The spouse places hands below the client's diaphragm and pushes upward with exhalation.
D. The spouse assists the client into high-Fowler position and encourage taking a number of deep breaths.
What is the nurse's best first action when a client with a spinal cord injury suddenly develops an SpO2 of 92% with stridor, bradycardia with decreased urine output, and a systolic blood pressure of 84 mm Hg?
A. Apply oxygen at 2 L per nasal cannula.
B. Place a large-bore IV access.
C. Insert a urinary catheter.
D. Notify the Rapid Response Team.
Which priority teaching points will the nurse provide for a client with a spinal cord injury who is treated with a halo fixator with vest? Select all that apply.
A. Be careful when leaning forward or backward because the weight of the halo device alters balance.
B. Wear loose clothing, preferably with large openings for head and arms.
C. Wash under the liner of the vest to prevent rashes or sores.
D. Support your head with a small pillow when sleeping to prevent unnecessary pressure and discomfort.
E. Do not drive because you can't turn your head from side to side so peripheral vision is impaired.
F. Increase fluids and fiber in the diet to prevent constipation.
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